Fertility treatment - rules and regulations

Fertility treatment in Bulgaria is attractive to foreign patients due to its competitive prices, short waiting lists, good international flight connections and foreign-language speaking doctors and nurses.

The reform of the Bulgarian national healthcare system started in 1997. It is ongoing with a number of issues still to be resolved, including not enough financing from the state budget, financial mismanagement, and poor access to healthcare and subsidised prescriptions by those living in small towns and villages.

When you are considering fertility treatment abroad, a good starting point is to decide which country offers the type of service and treatments that you need. As you may be spending some time there, perhaps combining your fertility treatment with a holiday, you also need to consider how you will enjoy the culture and lifestyle, and what tourism opportunities are available.

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Fertility treatment in Bulgaria

Fertility treatment in Bulgaria is attractive to foreign patients due to its competitive prices, short waiting lists, good international flight connections and foreign-language speaking doctors and nurses.

Patients from abroad are usually women over 35 years of age, who can no longer afford the cost of treatment in their own countries, find their country’s waiting lists too long, or have complicated infertility history.

Fertility clinics in Bulgaria are regulated under Ordinance 28 on Assisted Reproduction Activities by the Bulgarian Ministry of Health.

In Bulgaria:

• The age limit of women undergoing non-donor or donor-egg IVF treatment is 51 years of age.
• There are no restrictions on IVF treatment, and single women and female couples are not discriminated against when it comes to the cost of treatment.
• Egg, sperm and embryo donation is allowed.
• Sperm donors are over 18 years of age, with a good family medical history that does not indicate any likelihood of hereditary conditions. They are not from HIV/AIDS risk groups, are physically and mentally healthy, and have never had any serious illness or surgery. They have a normal semen analysis allowing freezing and successful thawing, have serologic testing for HIV, HBV & HCV, Syphilis and Chlamydia trachomatis and are tested for Thalassemia and Mucoviscidose.
• Egg donors have strong physical and mental health and a good family medical history that does not indicate any likelihood of hereditary conditions. They are not from HIV/AIDS risk groups, have serologic testing for HIV, HBV & HCV, Syphilis, Herpes, Cytomegalovirus, and Chlamydia trachomatis. They have had a complete gynaecological examination, have already had a child, are of normal weight, and are non-smokers or rarely smoke.
• There are no restrictions on egg, sperm or embryo freezing. However, freezing for up to five years is recommended under the Bulgarian legislation.
• Embryo screening (PGD and CGH) is permitted. Sex selection is allowed only for avoiding gender-specific hereditary diseases.
• Surrogacy: Legislation on surrogacy was being drafted at the end of 2011, but is not yet in place.

Availability

Fertility treatment is quite liberal in Bulgaria. As well as married couples, fertility treatment is available to unmarried couples, single mothers, and lesbian couples without any price discrimination. Sperm, egg and embryo donation are common practices.

Donor anonymity

Sperm donation is permitted, either by an anonymous donor or by the woman’s partner. Egg donation can be anonymous (donors are aged between 18 and 34), or by a sister or cousin (aged between 18 and 38). Egg donors should have given birth to at least one live child. Anonymous donors are selected from the clinic’s database. Their profiles includes blood type, weight and height, skin type, eye colour, hair type & colour, education and interests, smoking habits, and so on.

Donor offspring limits

A maximum of five live births per egg or sperm donor are permitted (including the donor’s own children).

Embryo transfer policies

The number of embryos to be transferred is decided individually and depends on the quality of the embryo, and the patient’s age, treatment and obstetric history. However, Ordinance 28 regulates the maximum number of embryos allowed for transfer and these limits depend on patient’s age and number of previous unsuccessful embryo transfers, as well as on the stage of embryo development.

Embryo storage rules

The Bulgarian legislation recommends embryo freezing for up to five years. If one of the partners dies, the couple’s embryos are destroyed. If a couple divorces, they need to present a notarised statement or a court judgment regarding the use of their frozen embryos.

The average cost for IVF treatment in Bulgaria is based on May 2012 prices and varies between clinics.

Cost in

USD

GBP

EURO

Single IVF cycle

$2,730

£1,700

€2,100

Stimulation medication costs (depending on how the patient responds to the stimulation)

$780 to &1,300

£480 to £800

€600 to €1,000

ICSI

$360

£270

€275

Egg donation: single cycle cost (including medication)

$5,200

£3,225

€4,000

Sperm donation per cycle

$260

£160

€200

Compare the cost of fertility treatment providers in Bulgaria

Cost of fertility treatment in Bulgaria

Price Factor

The price factor gives an indication of the cost of treatment in different countries and at different clinics.

It is based on the relative cost of one cycle of IVF treatment inclusive of all medicines, consultations and tests.

A score of 100 means that the cost is equivalent to the average cost at all clinics providing prices within our database. A score of less than 100 means that the cost is below average. A score of above 100 means that the cost is above average.

Compare fertility treatment providers in Bulgaria

The reform of the Bulgarian national healthcare system started in 1997. It is ongoing with a number of issues still to be resolved, including not enough financing from the state budget, financial mismanagement, and poor access to healthcare and subsidised prescriptions by those living in small towns and villages.

On the other hand, people in big cities benefit from all types of modern healthcare. Bulgarians do not need an advance appointment to see their GP, and can visit a doctor on the day required. There is no need to wait a long time to see a specialist, as if one is not available under the national healthcare service, it is possible to pay to see one privately. Fees for private consultations, examinations and tests are quite affordable and well below the EU average. As a rule, patients receive a copy of their medical records and tests.

Over the last few years, many reputable doctors have set up private clinics equipped with sophisticated medical equipment, offering reliable and affordable treatment with no waiting lists. As a result, Bulgaria is now an increasingly popular destination in Europe for medical tourism. Within easy reach of many EU cities, Sofia, Plovdiv and Varna have become destinations for medical treatment, as well as for tourists and the business community.

Fertility clinics in Bulgaria are privately owned with the majority of them being located in Sofia, Bulgaria’s capital city. The clinics have experience in providing sophisticated treatment with high success rates to foreign patients, who don’t have to wait long. Bulgaria is particularly popular with patients from Greece, the UK, Germany and Macedonia.

Fertility clinics in Bulgaria are privately owned with the majority of them being located in Sofia, Bulgaria’s capital city. The clinics have experience in providing sophisticated treatment with high success rates to foreign patients, who don’t have to wait long. Bulgaria is particularly popular with patients from Greece, the UK, Germany and Macedonia.

Bulgaria is a dynamic EU country, well known as a sea and ski holiday destination and for its yogurt and rose oil. It is famous for its football players and attractive women, and its tasty cuisine and red wine.

Bulgaria’s vibrant capital city, Sofia, is home to nearly one-fifth of the country’s population. It is a typical busy European city where IT, financial, commercial and administrative services flourish. At the same time, the city provides relaxation with its numerous green areas, sports and spa centres. Streets in Sofia, with their fancy shops, cafés and restaurants, are always buzzing with people. History and culture lovers can explore the ancient churches in Sofia. Concerts, intriguing exhibitions, public celebrations, and sports events take place on a regular basis, and the night life at the live music clubs is unmissable.

Sofia is also the city where most of the Bulgarian fertility clinics are located. They offer treatment over weekends to assist international patients, who can easily reach Sofia by regular direct flights from most European airports.

While enjoying a holiday or spa visit, visitors can also take advantage of the affordable, high-quality dental treatment on offer in Sofia.

Patients who are able to spend an additional week or two in Bulgaria after IVF treatment, can relax at leading spa hotels or visit more of the country. With more than 600 mineral springs with a flow of over 5000 litres per second, Bulgaria ranks among the top countries worldwide for mineral water resources. Most of the balneotherapy resorts are located in ecologically clean areas and nature parks. The most popular balneotherapy resorts are Sandanski, Kyustendil, Pomorie, Hisarya, Velingrad, Varshets, Devin and Shipkovo. There are also resorts whose locations mean they are particularly suited for the treatment of allergies and chronic respiratory diseases.